摘要
【目的】评估右美托咪定对全身麻醉下颅内动脉瘤介入治疗患者血流动力学及苏醒质量的影响。【方法】将本院全身麻醉下行动脉瘤栓塞术、ASA分级Ⅰ~Ⅱ级患者40例随机均分成两组（n=20），两组麻醉和诱导方法相同。右美托咪定组于麻醉诱导前15 min静脉输注右美托咪定0.6 μg/（kg·10 min），继之0.4 μg/（kg·h）持续输注；生理盐水组患者则静脉泵注相同剂量生理盐水。记录输注前、输注10 min、插管后、手术结束、拔管前、拔管后即刻及拔管后5 min、10 min时患者的平均动脉压（MAP）和心率（HR），苏醒时间、拔管时间、拔管时躁动、呛咳评分及拔管后10 min时Ramsay镇静评分。【结果】两组患者手术时间、苏醒和拔管时间相比较差异均无显著性（P〉0.05）。气管插管、拔管前、拔管即刻及拔管后5 min右美托咪定组患者MAP、HR显著低于生理盐水组患者（P均〈0.05）；拔管后10 min时Ramsay镇静评分高于生理盐水组患者，而呛咳反应评分、拔管即刻躁动评分均显著低于生理盐水组患者（P〈均0.05）。【结论】颅内动脉瘤介入治疗患者麻醉诱导前输注负荷剂量右美托咪定0.6 μg/（kg·10 min）、术中以0.4 μg/（kg·h）维持可稳定患者血流动力学，同时提高患者苏醒质量。
【Objective】To evaluate the effects of dexmedetomidine on hemodynamics and recovery quality for patients undergoing intracranial aneurysms embolism under general anesthesia. 【Methods】40 adult patients with ASA class Ⅰ~Ⅱ for aneurysm embolization were divided randomly into two groups （n=20）. All patients were anesthetized with the same scheme of induction and maintenance. The patients in group treated with dexmedetomidine received intravenously bolus dexmedetomidine 0.6 g/（kg·10min） 15 min prior to anesthesia followed by 0.4 g/（kg·h） during the operation. The patients in the saline group received the same dose of saline. HR and MAP were recorded preinfusion, 10 min after infusion, postintubation, end of the surgery, preextubation, immediately after extubation, 5 min after, and 10 min after. Waking time, extubation time, restless and cough score were observed and recorded. Sedation scores were evaluated and recorded with the Ramsay score after 10 min of extubation. 【Results】The operation time, waking, and extubation time were no different between both groups （P〉0.05）. MAP and HR were significantly lower in patients of group dexmedetomidine than patients in group saline at the time of intubation and preextubation, extubation and 5 min after extubation （P〈 0.05）. Ramsay sedation scores were higher in patients of the dexmedetomidine group than in patients of group saline at the time of 10 min after extubation, and cough score, agitation score were significantly lower in patients of group dexmedetomidine than patients of group saline （P〈0.05）. 【Conclusion】It is helpful to stabilize hemodynamics and improve recovery quality when the patients undergoing intracranial aneurysms embolism are administered dexmeditomidine intravenously with bolus 0.6 g/（kg·10min） and followed by 0.4 g/（kg·h）.
出处
《医学临床研究》
CAS
2016年第2期223-225,共3页
Journal of Clinical Research
基金
江苏大学临床医学科技发展基金项目（项目编号：JLY20140070）
